tbuckley/cabot-search huggingface dataset:
Reevaluation of the role of cellular hypoxia and bioenergetic failure in sepsis
Authors: R. S. Hotchkiss
Journal: JAMA (1992)

Sepsis is frequently characterized by a number of metabolic abnormalities: increased plasma lactate concentration, metabolic acidosis, increased glycolysis, and an abnormal "delivery-dependent" oxygen consumption. Two hypotheses have been advanced to explain these metabolic abnormalities: (1) cellular hypoxia resulting from abnormal microcirculatory blood flow or (2) defect(s) in energy-producing metabolic pathways of cells. Results of our studies on rat muscle, liver, heart, brain, and plasma suggest that there is no evidence of bioenergetic failure in these septic tissues and that the increase in lactate production is not necessarily due to cellular hypoxia. The adequacy of cellular oxygenation and bioenergetics was verified using in vivo phosphorus 31 nuclear magnetic resonance spectroscopy, [<sup>18</sup>F]fluoromisonidazole, and microfluorometric enzymatic techniques. Findings from these studies as well as results from several clinical investigations indicate that neither hypothesis can adequately account for the metabolic features typical of sepsis and that the pathophysiology of sepsis awaits further clarification. These studies and important clinical implications are discussed. (<i>JAMA</i>. 1992;267:1503-1510)
Coinfection with human T-cell lymphotropic virus type I and HIV in Brazil. Impact on markers of HIV disease progression
Authors: M. Schechter
Journal: JAMA (1994)

<h3>Objectives.</h3> —To study the effect of human T-cell lymphtropic virus type I (HTLV-I) on markers of human immunodeficiency virus (HIV) disease progression. <h3>Design.</h3> —A retrospective, nested case-control study. <h3>Setting.</h3> —A university hospital outpatient HIV clinic in Rio de Janeiro, Brazil. <h3>Participants.</h3> —Human immunodeficiency virus—seropositive adults participating in a prospective HIV cohort study. <h3>Main Outcome Measures.</h3> —The HIV clinical stage, CD4<sup>+</sup>lymphocyte counts, and other laboratory parameters in 27 individuals infected with HIV and HTLV-I (coinfection) and 99 age-matched, HIV-seropositive, HTLV-seronegative controls (single infection). <h3>Results.</h3> —Variables independently associated with coinfection included higher CD4<sup>+</sup>lymphocyte count (odds ratio [OR], 2.3; 95% confidence limits [CL], 1.3,4.1), higher CD4<sup>+</sup>percentage (OR, 2.0; 95% CL, 1.3, 3.2), β<sub>2</sub>-microglobulin level of 254 nmol/L or more (OR, 6.8; 95% CL, 1.3, 35.4), World Health Organization stages 3 and 4 (OR, 4.4; 95% CL, 1.1,18.0), and reporting a parenteral risk factor (OR, 7.4; 95% CL, 1.4, 38.9). When stratified by p24 antigenemia, coinfection was associated with an estimated 82% higher CD4<sup>+</sup>lymphocyte count (<i>P</i>&lt;.05). <h3>Conclusion.</h3> —Coinfection was associated with higher CD4<sup>+</sup>lymphocyte counts, more advanced clinical disease, and higher β<sub>2</sub>-microglobulin levels than HIV infection alone. The higher mean CD4<sup>+</sup>lymphocyte count does not appear to offer immunologic benefit. Caution should be exercised when using CD4<sup>+</sup>lymphocytes as a surrogate marker in studies of HIV infection in populations where HTLV-I is prevalent. Further studies are needed to address whether current CD4<sup>+</sup>lymphocyte values for the initiation of antiretroviral therapy and chemoprophylaxis against opportunistic infections in HIV infection are appropriate in coinfection. (<i>JAMA</i>. 1994;271:353-357)
Aprindine Hepatitis
Authors: H. FRANKLIN HERLONG
Journal: Annals of Internal Medicine (1978)

We have seen two patients whose hepatitis was due to the administration of aprindine, a new antiarrhythmic agent. In both patients evidence of hepatitis appeared within 3 weeks of initiating aprindine therapy and resolved rapidly when the drug was withdrawn. The reintroduction of aprindine in one patient was associated with the reappearance of hepatitis, which resolved despite continued administration of the drug.
P08.27 * LEPTOMENINGEAL METASTASES: A RANO PROPOSAL FOR RESPONSE CRITERIA
Authors: M. Chamberlain, L. Junck, D. Brandsma, R. Soffietti, R. Ruda, J. Raizer, W. Boogerd, S. Taillibert, M. D. Groves, E. Le Rhun
Journal: Neuro-Oncology (2014)

BACKGROUND: Leptomeningeal metastasis (LM) currently lacks standardization with respect to response assessment. METHODS: Investigators with expertise in LM developed a consensus proposal for evaluating patients treated with LM. RESULTS: Three basic elements in assessing response in LM are proposed; a standardized neurological examination, CSF cytology or parametric flow cytometry and radiographic evaluation. The group recommends that all patients enrolling in clinical trials undergo CSF analysis (cytology in all cancers; flow cytometry in hematologic cancers), complete contrast-enhanced neuraxis MRI and in instances of planned intra-CSF therapy, radioisotope CSF flow studies. In conjunction with the Response Assessment in Neuro-Oncology (RANO) Neurological Assessment Working Group, a standardized instrument was created for assessing the neurological exam in patients with LM. Response based on CSF cytology is considered when CSF converts from positive to negative at all previously positive sites, and with a confirmatory determination after 4 weeks. CSF flow cytometry is a quantitative analysis that also utilizes a binary outcome, i.e. positive or negative. Either CSF cytology (assessed in all patients) or CSF flow cytometry (assessed in patients with hematologic cancers), if unresponsive, constitutes progressive (refractory) disease irrespective of neurological or radiological determination. Considering that most lesions in LM are non-measurable and that assessment of neuroimaging in LM is subjective, neuroimaging is graded as stable, progressive or improved using radiological LM response criteria. Radiographic disease progression in isolation i.e. negative CSF cytology/flow cytometry and stable neurological assessment would be defined as LM disease progression. CONCLUSIONS: RANO LM has proposed a method of response evaluation for patients with LM that will require further testing, validation and likely refinement with use.
Abstract MP089: Cardiovascular Protection Profile and All-cause and CVD Mortality among U.S. Adults
Authors: Quanhe Yang, Mary Cogswell, W. Dana Flanders, Yuling Hong, Zefeng Zhang, Fleetwood Loustalot, Cathleen Gillespie, Robert Merritt, Frank Hu
Journal: Circulation (2012)

Introduction: Epidemiologic studies suggest that multiple cardiovascular (CVD) protection-factors (i.e., non-smoking, physically active, normal blood pressure, normal blood glucose, normal total cholesterol, non-obese, and healthy diet) are associated with significantly reduced risk of cardiovascular disease incidence and mortality. Hypothesis: We assessed the hypothesis that the increased number of CVD protection-factors is associated with reduced risk for all-cause and CVD mortality and adherence to low CVD risk profile could result in significant lower rates of all-cause and CVD mortality. Methods: We used the Third National Health and Nutrition Examination Survey (NHANES III 1988-1994) Linked Mortality File (through 2006), a prospective cohort study of a nationally representative sample of 12,861 U.S. adults to examine the prevalence, associations, and population attributable fraction (PAF) of seven CVD protection-factors in relation to risk of all-cause and CVD mortality. Results: Only 3.1% of U.S. adults had all seven CVD protection-factors. The average follow-up was 14.5 years. After multivariable adjustment for potential confounders, hazard ratios (HR) were: 0.30 (95% CI 0.22-0.40), 0.21 (0.12-0.34), and 0.17 (0.09-0.32), comparing individuals with ≥six protection-factors to those with ≤one protection-factors for all-cause, CVD, and IHD mortality respectively. Elevated blood pressure was responsible for the largest number of all-cause and CVD death followed by smoking and poor diet. Overall, 59% (95% CI 27-78) of total deaths and 66% (95% CI 22-88) CVD death would have been avoided during the average of 14.5 years follow-up if the population were changed to the high CVD protection-factors status (with ≥six protection-factors). Conclusions: Few adults in this U.S.-based study population had all seven desirable CVD protection-factors. The presence of an increasing number of CVD protection-factors was associated with a progressively lower risk of total and CVD mortality. Comprehensive population-based initiatives are needed to improve modifiable CVD risk factors, resulting in substantial reductions of all-cause and CVD mortality in the U.S. population.
OCULAR DEFECTS AND HEADACHE.
Journal: JAMA (2002)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Reply
Authors: Chunping Wang, Ke‐Qin Hu, Yongping Yang
Journal: Hepatology (2015)

Potential conflict of interest: Nothing to report. We thank Professor Lo for the interest in our study and the results. As indicated, studies have suggested that antiviral therapy in patients with hepatitis B virus (HBV)–related cirrhosis and/or hepatocellular carcinoma (HCC) and detectable HBV DNA may reduce hepatic decompensation and potentially prevent HCC recurrence. Actually, our study included 338 patients with HBV infection; 320 patients met the criteria based on the American Association for the Study of Liver Diseases/European Association for the Study of the Liver guidelines and received antiviral therapy with oral entecavir (0.5 mg, once a day). The other 18 patients with HBV infection were not on antiviral therapy due to undetectable serum HBV DNA. Because all of the patients meeting the indication for antiviral therapy received oral entecavir and there were no significant differences between the two groups, HBV treatment should not impact our final results as originally reported. We agree that patients with HCC who fail treatment with either cryoablation or radiofrequency ablation (RFA) could be offered an alternative complementary treatment, although Barcelona Clinic Liver Cancer Group HCC management guidelines do not recommend RFA due to a marked decrease in efficacy when the tumor size exceeds 3 cm.1 Indeed, with improved devices and techniques, many studies have reported encouraging results, including complete ablation and survival rates of RFA in treating HCC lesions >3 cm.2 In our study, patients with incomplete ablation after two sessions of the same technique were considered treatment failures and were further treated by percutaneous ethanol injection, microwave, RFA, cryoablation, or surgery, as appropriate. Our study was performed between February 2008 and October 2013, and six patients in the RFA group did not undergo an additional course of RFA treatment as they declined the option of RFA or cryoablation for additional treatment. It should be noted that this study included 158 patients with 168 HCC lesions 3.1‐4 cm (84 patients in the cryoablation group and 74 in the RFA group, P = 0.2882). Hence, some of the patients with incomplete ablation (three patients in the cryoablation group and six patients in the RFA group) received percutaneous ethanol injection treatment alone, which should not significantly influence the local tumor progression rate only in the RFA group. Indeed, the main conclusion of this study was the demonstration that percutaneous cryoablation can be effective for HCC lesions up to 4 cm in diameter. Our study was not aimed at determining if cryoablation is superior to RFA in treating larger HCC lesions (i.e., 3.1‐4.0 cm in diameter).
A New Method of Treating Pulmonary Complaints.
Journal: JAMA (1885)

—Diseases of the lungs have long been treated by the inhalation of condensed or rarefied air. Waldenberg, of Berlin, was one of the pioneers in this direction, and his apparatus, or some modification of it, by which patients are made to inspire condensed air, is largely used in Germany. At various health resorts —notably, Reichenhall—pneumatic cabinets have been erected with a view to completely immersing the patient in a condensed atmosphere. Reports concerning the efficacy of such contrivances are somewhat conflicting, except in cases of vesicular emphysema and chronic bronchitis, where great benefit is often derived. The physiological effects of such treatment are pretty well understood, and are recognized to be essentially the same as those of a prolonged and forcible inspiration of air at ordinary pressure. Indeed, to supply condensed air, or in other words, air at an increased pressure, to an individual incapable of respiring effectively, is but
Manuscripts Approved for JNCI, July-August 1972
Journal: JNCI Journal of the National Cancer Institute (1972)

Manuscripts Approved for JNCI, July-August 1972 Get access JNCI: Journal of the National Cancer Institute, Volume 49, Issue 3, September 1972, Pages 925–926, https://doi.org/10.1093/jnci/49.3.925 Published: 01 September 1972
Abstract 5592: In Acute Coronary Syndromes Being Totally Revascularized Is As Good As Having A Normal Coronary Angiogram
Authors: Rogerio Teixeira, Carolina Lourenco, Elisabete Jorge, Rui Baptista, Natalia Antonio, Silvia Monteiro, Pedro Monteiro, Mario Freitas, Luis A Providencia
Journal: Circulation (2008)

Background: Revascularization is a crucial therapy in acute coronary syndromes (ACS). Purpose: to assess ACS patients outcomes, stratified according to the coronary angiography and/or angioplasty. Population and methods: 786 consecutive ACS patients submitted to an invasive strategy, divided in 3 groups: A (n=111) normal coronary angiogram; B (n=327) fully revascularized; C (n=348) incomplete revascularization. A 1-year follow up targeting major adverse cardiovascular events (MACE) was performed. Results: Group A had more females (38.7 vs 21.1 vs 24.4% p&lt;0.01), patients were more admitted for unstable angina (37.3 vs 14.9 vs 17.9% p&lt;0.01) and had a higher left ventricular ejection fraction (LVEF). Group B were more on previous statin therapy, had more often an admission for ST elevation acute myocardial infarction (17.3 vs 51.7 vs 42.4% p&lt;0.001) and higher peak levels of cardiac biomarkers. Group C were older and had more frequently a previous history of coronary disease. Group C patients had a worse in-hospital mortality (1.8 vs 1.2 vs 7.5% p&lt;0.01) and morbidity. The MACE free survival rate was significantly lower for group C (92.9% vs. 92.9% vs. 78.2%; log rank p&lt;0.001). In a multivariate Cox regression analysis, incomplete revascularization remained an independent predictor of MACE at 1 year (HR 2.74, CI 1.50 – 4.94), in a model that included, age, gender, LVEF, diabetes, coronary anatomy, and admission diagnosis. Conclusion: Our data strongly support the use of an aggressive invasive strategy in ACS, aimed at achieving full revascularization, as these patients had the same medium term prognosis as those with normal coronary angiogram.
A couple with infertility
Authors: J. A. Collins
Journal: JAMA (1995)

<h3>Dr Daley</h3> : Mrs B is a 32-year-old paralegal. Married for 5 years to Mr B, a 32-year-old manager, they have been trying to conceive since 1992. They are both members of a health maintenance organization and live in Massachusetts, where health insurance coverage of infertility and advanced reproductive technologies is mandated by the state. In good health, Mrs B has never been pregnant and used oral contraceptives for 4 years before attempting pregnancy. Her menarche was at 12 years of age, with her cycles occurring every 28 days, lasting 4 days, with spotting between day 22 and day 25. In July 1993, after 1 year of attempting to conceive, the patient was referred by her primary physician to an infertility specialist. Mrs and Mr B then sought care from Dr T, another infertility specialist. Mrs B's past medical history is unremarkable except for a family history of fibrocystic breast disease.
Quality health care
Authors: L. A. Headrick
Journal: JAMA (1995)

Health professionals are reporting progress in the application of improvement principles and methods to clinical care. One year ago we wrote, "Continuous improvement is a reality in clinical medicine.... Examples of improvement in direct patient care finally have emerged in the literature."<sup>1</sup>The pace is increasing. A recent MEDLINE search of the entries "total quality management" combined with "clinical" from 1985 to 1994 revealed 125 English-language citations, with 91 written from 1991 through 1994. A similar search of the entries "continuous quality improvement" combined with "clinical" uncovered 82 articles, all but 15 published after 1991. The most successful efforts combine professional knowledge (such as pathogenesis and therapeutics) with "knowledge for improvement," as described by Batalden and Nolan<sup>2</sup>and elaborated on by Batalden and Stoltz.<sup>3</sup>Knowledge for improvement incorporates an understanding of systems, statistical variation, the psychology of work and change, and the scientific method. We will focus
A Manual of Materia Medica for Medical Students.
Journal: JAMA (1927)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Propylthiouracil-induced agranulocytosis in four patients previously treated with the drug
Authors: A. Shiran
Journal: JAMA (1991)

<h3>To the Editor.</h3> —Agranulocytosis is a well-known major complication of antithyroid drug treatment. Most studies emphasize the initial period of drug treatment (1 to 3 months), as that in which agranulocytosis is most likely to happen.<sup>1-3</sup>We found only one case report of agranulocytosis in the second course of propylthiouracil (PTU) treatment,<sup>4</sup>and a few more cases on methimazole.<sup>3,5</sup>We report here four cases of agranulocytosis on second exposure to PTU. We think it is important to draw attention to the possibility of agranulocytosis in patients who were previously treated successfully with PTU. <h3>Study.</h3> —The records of all our patients who were treated with PTU for thyrotoxicosis in the years 1985 through 1990 were reviewed. The diagnosis of thyrotoxicosis was made on the basis of symptoms, physical findings, elevated thyroid function tests (total thyroxine [T<sub>4</sub>], triiodothyronine uptake [T<sub>3</sub>U], and free thyroxin index), and suppressed
CARCINOMA OF THE PANCREAS WITH ULCERATION INTO THE GASTRO-INTESTINAL TRACT
Journal: JAMA (1921)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Limitations of bone scanning in clinical oncology
Authors: R. K. Loeffler
Journal: JAMA (1975)

Radioisotope bone scanning is frequently used as the major, and sometimes the only, diagnostic test for neoplasia in bone. While the evidence is convincing that bone scans are frequently more sensitive than roentgenographic bone surveys for detection of metastatic bone disease, there are false-negative results for a variety of reasons, and positive findings must be interpreted with caution. Scans also appear more limited than roentgenograms in their usefulness for evaluating changes in abnormal bone structure. Case histories and discussion are offered to indicate that usually both radioisotope bone scans and roentgenographic bone surveys should be obtained for initial screening and subsequent assessment of bone metastases. (<i>JAMA</i>234:1228-1232, 1975)
Brain Mechanisms and Intelligence: A Quantitative Study of Injuries to the Brain.
Journal: JAMA (1930)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal